Bioethics, Volume 36, Issue 1, Page 63-70, January 2022.

Part of a symposium devoted to ‘Prediction, Understanding, and Medicine’, in which Alex Broadbent argues that the nature of medicine is determined by its competences, i.e., which things it can do well. He argues that, although medicine cannot cure well, it can do a good job of enabling people not only to understand states of the human organism and of what has caused them, but also to predict future states of it. From this Broadbent concludes that (...) medicine is (at least in part) essentially a practice of understanding and predicting, not curing. In reply to this bold position, I mount two major criticisms. First, I maintain that the reasons Broadbent gives for doubting that medicine can cure provide comparable reason for doubting that medicine can provide an understanding; roughly, the best explanation of why medicine cannot reliably cure is that we still lack much understanding of health and disease. Second, I object to the claim that a practice is medical only if it facilitates understanding and prediction. Although Broadbent has brought to light certain desirable purposes of medicine that are under-appreciated, my conclusion is that he has not yet provided enough reason to think that understanding and prediction are essential to it. Instead of supposing that medicine has an essence, in fact, I suggest that its nature is best understood in terms of a property cluster. (shrink)

According to Aristotle, the medical art aims at health, which is a virtue of the body, and does so in an unlimited way. Consequently, medicine does not determine the extent to which health should be pursued, and “mental health” falls under medicine only via pros hen predication. Because medicine is inherently oriented to its end, it produces health in accordance with its nature and disease contrary to its nature—even when disease is good for the patient. (...) Aristotle’s politician understands that this inherent orientation can be systematically distorted, and so would see the need for something like the Hippocratic Oath. (shrink)

Physicians frequently ask whether they should give patients what they want, usually when there are considerations pointing against doing so, such as medicine’s values and physicians’ obligations. It has been argued that the source of medicine’s values and physicians’ obligations lies in what has been dubbed “the internal morality of medicine”: medicine is a practice with an end and norms that are definitive of this practice and that determine what physicians ought to do qua physicians. In (...) this paper, I defend the claim that medicine requires a morality that is internal to its practice, while rejecting the prevalent characterization of this morality and offering an alternative one. My approach to the internal morality of medicine is constructivist in nature: the norms of medicine are constructed by medical professionals, other professionals, and patients, given medicine’s end of “benefitting patients in need of prima facie medical treatment and care.” I make the case that patients should be involved in the construction of medicine’s morality not only because they have knowledge that is relevant to the internal morality of medicine—namely, their own values and preferences—but also because medicine is an inherently relational enterprise: in medicine the relationship between physician and patient is a constitutive component of the craft itself. The framework I propose provides an authoritative morality for medicine, while allowing for the incorporation, into that very morality, of qualified deference to patient values. (shrink)

The first part of a symposium devoted to Alex Broadbent's essay titled ‘Prediction, Understanding and Medicine’, this article notes the under-development of a variety of issues in the philosophy of medicine that transcend bioethics and the long-standing debates about the nature of health/illness and of evidence-based medicine. It also indicates the importance of drawing on non-Western, and particularly African, traditions in addressing these largely metaphysical and epistemological matters.

This paper begins the last instalment of a six-part project correlating the key aspects of Kant’s architectonic conception of philosophy with a special version of the Chinese Book of Changes that I call the “Compound Yijing”, which arranges the 64 hexagrams (gua) into both fourfold and threefold sets. I begin by briefly summarizing the foregoing articles: although Kant and the Yijing employ different types of architectonic reasoning, the two systems can both be described in terms of three “levels” of elements. (...) Starting at an unnumbered level devoid of any element (the tao or thing in itself), the system proceeds by elaborating a key fourfold distinction (or “quaternity”) on the first level, a twelvefold distinction on the second level, and twelve quaternities (grouped in four quadrants, each with a set of three quaternities) on the third level. Each set of three quaternities (i.e., each quadrant) on the third level corresponds to one of the four “faculties” of the university, as elaborated in Kant’s book, The Conflict of the Faculties. Previous papers have examined the correlations between three key quaternities that Kant defends in relation to each of three faculties (philosophy, theology, and law) and the 12 gua that correspond to that faculty in the Compound Yijing. The final step is to explore the fourth quaternity on the third level, the 12 gua corresponding to the medical faculty. The “idea of reason” in Kant’s metaphysics that guides this wing of the comparative analysis is freedom, and the ultimate purpose of this faculty of the university is to train doctors to care for people’s physical well-being, as free agents imbedded in nature. But this paper will focus only on the four gua that correspond to four basic concepts in Kant’s theory of medicine. The two quaternities in the “yin-yang” (medical) quadrant of the Compound Yijing that will be skipped here are as follows. First, Kant’s account of the idea of freedom itself, which gives rise to the area of traditional metaphysics known as rational cosmology, comes in the first Critique’s Dialectic, in the section on the Antinomy of Reason (CPR A405-567/B432- 595). There he examines four irresolvable issues: whether the world has a beginning in time; whether composite substances consist of simple parts; whether a causality of freedom operates in the natural world; and whether an absolutely necessary being exists. Later I will argue that these correspond to the quaternity consisting of gua 15, 22, 36, and 52. (shrink)

This paper was written to study the order of medical advances throughout history. It investigates changing human beliefs concerning the causes of diseases, how modern surgery developed and improved methods of diagnosis and the use of medical statistics. Human beliefs about the causes of disease followed a logical progression from supernatural causes, such as the wrath of the Gods, to natural causes, involving imbalances within the human body. The invention of the microscope led to the discovery of microorganisms which were (...) eventually identified as the cause of infectious diseases. Identification of the particular microorganism causing a disease led to immunization against the disease. Modern surgery only developed after the ending of the taboo against human dissection and the discovery of modern anesthesia and the discovery of the need for anti-septic practices. Modern diagnostic practices began with the discovery of x-rays and the invention of medical scanners. Improved mathematics, especially in probability theory, led to statistical studies which led to a much greater ability, to identify the causes of disease, and to evaluate the effectiveness of treatments. These discoveries all occurred in a necessary and inevitable order with the easiest discoveries being made first and the harder discoveries being made later. The order of discovery determined the course of the history of medicine and is an example of how social and cultural history has to follow a particular course determined by the structure of the world around us. (shrink)

In this paper, I explore the nature of medical interventions like neuromodulation on the complex human experience of love. Love is built upon two fundamental natures, viz: the biological and the psychosocial. As a result of this distinction, scientists, and bioethicists have been exploring the possible ways this complex human experience can be biologically tampered with to produce some supposed higher-order ends like well-being and human flourishing. At the forefront in this quest are Earp, Sandberg and Savulescu whose research (...) works over ten years has focused on the good that could stem from the medicalization of love. I acknowledge the various criticisms that have been made against this stance. However, most of these criticisms have been directed towards the mere side effects and sociocultural disservices that could result from the process of using drugs to influence human romantic relationships and in the end, critiques endorse the medicalization of love on the basis that its benefits outweigh the disadvantages. Consequently, I advance two strands of arguments against “medically-assisted love,” the ontological and the socio-ethical arguments. The former presupposes that beyond the possible side effects of medicalizing love there is something inherently mistaken about this effort and there is something intrinsically different about love that distinguishes it from its medically-engineered alternative. In the latter argument, I claim that drug interventions in romantic love contravene the very nature of medicine. Overall, I believe that critiques were still able to endorse medicalizing love despite their objections because they were only looking at one direction, the physical/cultural complications. (shrink)

For many philosophers, the relation of medicine to health is exemplary for understanding the relation of human power to nature in general. Drawing on Heidegger and Aquinas, this paper examines the relation of art to nature as it emerges in the second book of Aristotle’s Physics, and it does so by articulating the duality of efficient causality. The art of medicine operates as a dispositive cause rather than as a perfective cause; it removes obstacles to the (...) achievement of health, but it does not impose health. Medicine, on this conception, aids the efficient causality of the natural body rather than substituting for it. The loss of dispositive causality makes efficient causality an imposition of force that bypasses the natural power to achieve natural goods. The paper concludes, with Plato, by arguing that dispositive causality offers a way to understand not only medicine but also governing, teaching, and parenting. (shrink)

Philosophical problems arise in every sphere of the science. Philosophers should be able to recognize an issue and give a reasonable response. Medicine is an especial sphere, where one can discover many philosophical questions about the nature of human health and diseases, limits of scientific methodology, etc. Since ancient times, philosophers have been engaged in medicine. Pythagoras, Empedocles, Democritus, Aristotle, Avicenna, René Descartes were famous in both areas: philosophy and medicine. Nowadays, links between these spheres in (...) their strong meaning are reflected in three types: philosophy for medicine, philosophy in medicine and philosophy of medicine. (shrink)

In this paper, I open an inquiry that provides a catalyst for the inauguration of African Philosophy of Medicine and Bioethics (APMB) as a full-fledged academic pursuit. I situate this inquiry within the quest of early professional African philosophers for a stirring of the course of contemporary African philosophy along the path of critically retrieving, clarifying, and articulating aspects of traditional African culture and practices in the light of social pluralism and modernization. The case I make for the establishment (...) of this discipline and my effort to delineate its nature, scope, and method hinge on three important realities: (i) The existence of African Traditional Medicine (ATM); (ii) the existence of philosophical puzzles in ATM that require conceptual, metaphysical, epistemological, ethical, and socio-political analyses; and (iii) the need to carry out this analysis in the context of the twenty-first-century reality of medical pluralism and globalization. Solidifying my effort to map out the landscape of this new enterprise, in the concluding part of this paper, I make recommendations on the direction the discipline is to take if it must fulfil its goal of providing a framework for the improvement of medical knowledge and practice in contemporary Africa. (shrink)

In this chapter we will argue, firstly, that Bacon’s engages in a pecu-liar form of mathematization of nature that develops a quali-quantitative methodology of measurement. Secondly, we will show that medicine is one of the disciplines where that dual way of measurement is practiced. In the first section of the chapter, we will expose the ontology involved in the Baconian proposal of measurement of nature. The second section will address the place that mixed mathematics occupies in Bacon’s (...) scheme of scientific branches and will suggest that a proper advancement of medicine can generate a new branch of mixed mathematics. The next section will reconstruct Bacon’s approach to measurement and expose its quali-quantitative import. In the last section, we will show some examples of medicine in which this quali-quantitative measurement is applied. (shrink)

The articles in the special issue "Experience in natural philosophy and medicine" discuss the roles and notions of experience in the works of a range of early modern authors, including Galileo Galilei, Francis Bacon, the Dutch atomist David Gorlaeus, William Harvey, and Christian Wolff. The articles extend the evidential basis on which we can rely to identify trends, changes and continuities in the roles and notions of experience in the period of the Scientific Revolution. They shed light on the (...) longstanding influence of traditional views and the emergence of early modern experimental philosophy. This introduction highlights the benefits of considering medicine in connection with natural philosophy when studying early modern views on experience and summarizes the articles. (shrink)

This paper asks when a natural disease kind is truly 'reactive' and when it is merely associated with a corresponding social kind. I begin with a permissive account of real kinds and their structure, distinguishing natural kinds, indifferent kinds and reactive kinds as varieties of real kind characterised by super-explanatory properties. I then situate disease kinds within this framework, arguing that many disease kinds prima facie are both natural and reactive. I proceed to distinguish ‘simple dependence’, ‘secondary dependence’ and ‘essential (...) dependence’ between a natural kind and its classification, and argue that a natural kind is only really reactive, in an important sense, under conditions of essential dependence. On this basis, I offer a principled hypothesis for why psychiatric kinds tend to be more metaphysically unstable than paradigm somatic disease kinds. (shrink)

As a way to make medical decisions, Evidence-Based Medicine (EBM) has failed. EBM's failure arises from not being founded on real-world decision-making. EBM aspires to a scientific standard for the best way to treat a disease and determine its cause, but it fails to recognise that the scientific method is inapplicable to medical and other real-world decision-making. EBM also wrongly assumes that evidence can be marshaled and applied according to an hierarchy that is determined in an argument by authority (...) to the method by which it has been obtained. If EBM had valid theoretical, practical or empirical foundations, there would be no hierarchy of evidence. In all real-world decision-making, evidence stands or falls on its inherent reliability. This has to be and can only be assessed on a case-by-case basis applying understanding and wisdom against the background of all available facts—the "factual matrix." EBM's failure is structural and was inevitable from its inception. EBM confuses the inherent reliability and probative value of evidence with the means by which it is obtained. -/- EBM is therefore an ad hoc construct and is not a valid basis for medical decision-making. This is further demonstrated by its exclusion of relevant scientific and probative real-world decision-making evidence and processes. It draws upon a narrow evidence base that is itself inherently unreliable. It fails to take adequate account of the nature of causation, the full range of evidence relevant to its determination, and differing approaches to determining cause and effect in real-world decision-making. EBM also makes a muddled attempt to emulate the scientific method and it does not acknowledge the role of experience, understanding and wisdom in making medical decisions. (shrink)

The paper aims at reconstructing the fundamentals of the sophistic anthropology. Contrary to the recognized view of the humanistic shift which took place in the sophistic thought, there is evidence that the sophists were continuously concerned with the problems of philosophy of nature. The difference between the sophists and their Presocratic predecessors was that their criticism of the philosophical tradition and the transformative answers given to the old questions were the basis and the starting point of the " ethical (...) " and " rhetorical " part of their intellectual activity. This natu-ralistic perspective is reflected in their research in the field of medicine and biology, in the discussion about " the human nature " , and in their interest in the individual physiological and mental conditions, which determine the state of the human body and the behaviour of a man. The sophists pioneered in linguistic, rhetorical, and philological studies. To enhance the power of persuasion, they investigated how various mental conditions influenced cognitive processes and physiological reactions. Thus they started a thorough examination of the human psyche, initiating the field of psychology. (shrink)

It is easier to talk frankly to a person whom one trusts. It is also easier to agree with a scientist whom one trusts. Even though in both cases the psychological state that underlies the behavior is called ‘trust’, it is controversial whether it is a token of the same psychological type. Trust can serve an affective, epistemic, or other social function, and comes to interact with other psychological states in a variety of ways. The way that the functional role (...) of trust changes across contexts and objects is further complicated when communities and individuals mediate it through technologies, and even more so when that mediation involves artificial intelligence (AI) and machine learning (ML). In this chapter I look at the ways in which trust in institutions, and specifically the medical profession, is affected by the use of AI and ML. There are two key elements of this analysis. The first is a disanalogy between institutional trust in medicine and institutional trust in science (Irzik and Kurtulmus 2021, 2019; Kitcher 2001). I note that as AI and ML become a more prominent part of medicine, trust in a medical institution becomes more like trust in a scientific institution. This is problematic for institutional trust in medicine and the practice of medicine, since institutional trust in science has been undermined by, among other things, the spread of misinformation online and the replication crisis (Romero 2019). There is also a strong analogy between the psychological state of the person who trusts a scientific report or testimony and the psychological state of a patient who trusts individual recommendations made by a medical professional in a clinical setting. In both cases, institutional trust makes it less likely that a mistake or malfeasance will result in reactive attitudes, such as blame or anger, directed at other individual members of that institution. However, it also renders people vulnerable enough to blame the institution itself. This, with time, can erode trust in the institution and naturally leads to policy recommendations that aim to preserve institutional trust. I survey two ways in which that can be done with institutional trust in medicine in the age of AI and ML. (shrink)

The evidence-based medicine (EBM) movement is touted as a new paradigm in medical education and practice, a description that carries with it an enthusiasm for science that has not been seen since logical positivism flourished (circa 1920–1950). At the same time, the term ‘‘evidence-based medicine’’ has a ring of obviousness to it, as few physicians, one suspects, would claim that they do not attempt to base their clinical decision-making on available evidence. However, the apparent obviousness of EBM can (...) and should be challenged on the grounds of how ‘evidence’ has been problematised in the philosophy of science. EBM enthusiasm, it follows, ought to be tempered. The post-positivist, feminist, and phenomenological philosophies of science that are examined in this paper contest the seemingly unproblematic nature of evidence that underlies EBM by emphasizing different features of the social nature of science. The appeal to the authority of evidence that characterizes evidence-based practices does not increase objectivity but rather obscures the subjective elements that inescapably enter all forms of human inquiry. The seeming common sense of EBM only occurs because of its assumed removal from the social context of medical practice. In the current age where the institutional power of medicine is suspect, a model that represents biomedicine as politically disinterested or merely scientific should give pause. (shrink)

From antiquity, Galenic physicians extensively discussed the active powers of simple and compound drugs. In their views, simple drugs, that is, single ingredients, acted according to their material qualities and the properties of their substance. As for compound drugs, their efficacy resulted from the mutual interaction of their ingredients and their modes of preparation. In the late Renaissance, Galenic physicians and naturalists, such as Leonhart Fuchs and Pietro Andrea Mattioli, attempted to explain these pharmacological properties or “faculties” at the intersection (...) of medicine, botany, and natural philosophy. This chapter examines the case of the Italian physician and botanist Andrea Cesalpino. His pharmacological treatise De medicamentorum facultatibus [On the Faculties of Drugs, 1593] was particularly significant for its reception of ancient and medieval texts on drug properties, materia medica, and the role of the senses in the knowledge of bodies. (shrink)

Oliva Sabuco's New Philosophy of Human nature (1587) is an early modern philosophy of medicine that challenged the views of the successors to Aristotle, especially Galen and Ibn Sina (Avicenna). It also challenged the paradigm of the male as the epitome of the human and instead offers a gender-neutral philosophy of human nature. Now largely forgotten, it was widely read and influential amongst philosophers of medicine including DeClave, LePois, Harvey,Southey and others, particularly for its account of (...) the role of the nervous system and cerebrospinal fluid in mind-body interaction. In this article I trace its early influence by tracing provenance of the editions produced during the lifetime of its author. (shrink)

This paper aims to clarify the nature of understanding in medicine. The first part describes in more detail what it means to understand something and links a type of understanding (i.e., objectual understanding) to explanations. The second part proceeds to investigate what objectual understanding of a disease (i.e., biomedical understanding) requires by considering the case of scurvy from the history of medi- cine. The main hypothesis is that grasping a mechanistic explanation of a condi- tion is necessary for (...) a biomedical understanding of that condition. The third part of the paper argues that biomedical understanding is necessary, but not sufficient for understanding in a clinical context (i.e., clinical understanding). The hypothe- sis is that clinical understanding combines biomedical understanding of a disease or pathological condition with understanding illness, which involves some degree of personal understanding of the patient. It is argued that, in many cases, clinical understanding necessitates adopting a particular second-personal stance and using cognitive resources in addition to those involved in biomedical understanding. (shrink)

Nature, according to Cavendish, has “an Infinite Natural power, that is, a power to produce infinite effects in her own self, by infinite changes of Motions.” While Cavendish mentions powers with respect to human beings, medicines, occasional causes, and other entities, these powers are really just the power of self-moving matter to cause changes in the world. This chapter examines why Cavendish attributes the power of self-motion to matter, what this power is, how it arose, how it is enacted, (...) and its limitations. In doing so, it discusses her views on causation, perception, and motion, and argues that motion is not reducible to change in mereological facts. (shrink)

The connections between medicine and well-being are myriad. This paper focuses on the place of well-being in clinical medicine. It is here that different views of well-being, and their connection to concepts like “autonomy” and “authenticity”, both illuminate and are illuminated by looking closely at the kinds of interactions that routinely take place between clinicians, patients, and family members. -/- In the first part of the paper, I explore the place of well-being in a paradigmatic clinical encounter, one (...) where a competent patient interacts with a clinician. The main question here is how, or even whether, the pursuit of patient well-being – however we construe it – figures into a paradigmatic clinical encounter. In the second part of the paper, I consider what I will call a marginal clinical encounter – one where the patient is, as Agnieska Jaworska (1999) puts it, at the “margins of agency” – to theorize about the nature of well-being and to show how different theories of well-being can have dramatic consequences for clinical decision-making. (shrink)

One of the most salient contemporary concerns in academic debates and pop culture alike is the extent to which new technologies may re-cast Homo sapiens. Species members may find themselves encased in a type of existence they deem to be wanting in comparison with their present form, even if the promised form was assured to be better. Plausibly, the concern is not merely fear of change or of the unknown, but rather it arises out of individuals’ general identification with what (...) they are and what their friends and family are. In altering that identity beyond a point, they lose it and thus lose themselves in a kind of living death. The three volumes analysed in this essay offer widely differing perspectives on the relations between humans and new technology. As the three works reviewed here together make clear, a whole, fully coherent, definitive work on the composite redesign of human nature (CROHN) still has yet to materialize. (shrink)

An appreciation of the "more philosophical" aspects of ancient medical writings casts considerable light on Aristotle's concept of nature, and how he understands nature to differ from art, on the one hand, and spontaneity or luck, on the other. The account of nature, and its comparison with art and spontaneity in Physics II is developed with continual reference to the medical art. The notion of spontaneous remission of disease (without the aid of the medical art) was a (...) controversial subject in the medical literature, and Aristotle's aporia about the notion of spontaneous generation of natural things runs parallel to this controversy. Aristotle's account of spontaneous generation in the Metaphysics and in the Generation of Animals can also be profitably illuminated by looking at the comparison with medicine in detail. The result, hopefully, is a clearer and more consistent picture not only of Aristotle's concepts of nature, art, and spontaneity, but also of the influence of medical writings and concepts on his natural philosophy. Joel Mann has written a commentary on the essay. (shrink)

A new world has probably emerged through the progression of technology which has led to significant debates on social, cultural, legal, and ethical issues, especially in the biomedical field in this century. Application of physician-patient relationship, principles of pluralism, autonomy, democracy, human dignity, and human rights is being challenged within the medicine and health-care system of today. Development of technology-based remedies has fostered greater degrees of medicalization. Hence, the automatic application of such technologies risks distorting the nature of (...) medicine. To be sure, there is a cultural shift that is affecting the society that is increasingly unable to adapt to traditional legal systems. This cultural shift, perhaps, demands new ethics. This entry aims to evaluate the gap between traditional deontological nature of medicine and the emerging new ethics and assess why bioethical reflection is needed. (shrink)

As medical technology advances and severely injured or ill people can be kept alive and functioning long beyond what was previously medically possible, the debate surrounding the ethics of end-of-life care and quality-of-life issues has grown more urgent. In this lucid and vigorous book, Craig Paterson discusses assisted suicide and euthanasia from a fully fledged but non-dogmatic secular natural law perspective. He rehabilitates and revitalises the natural law approach to moral reasoning by developing a pluralistic account of just why we (...) are required by practical rationality to respect and not violate key demands generated by the primary goods of persons, especially human life. Important issues that shape the moral quality of an action are explained and analysed: intention/foresight; action/omission; action/consequences; killing/letting die; innocence/non-innocence; person/non-person. Paterson defends the central normative proposition that ‘it is always a serious moral wrong to intentionally kill an innocent human person, whether self or another, notwithstanding any further appeal to consequences or motive’. (shrink)

This paper explores how transformative experience generates decision-making problems of particular seriousness in medical settings. Potentially transformative experiences are especially likely to be encountered in medicine, and the associated decisions are confronted jointly by patients and clinicians in the context of an imbalance of power and expertise. However in such scenarios the principle of informed consent, which plays a central role in guiding clinicians, is unequal to the task. We detail how the principle’s assumptions about autonomy, rationality and information (...) handle transformative experiences poorly, appealing to several difficult cases for medical decision-making to illustrate the resulting problem, and we consider how the existing literature on complications with consent fails to offer a resolution. We argue that recognition of the problem has a role to play in achieving a more effective response to transformative decisions. In Sect. 1 we introduce several representative cases of challenging patient decision-making that clinicians might face. In Sect. 2 we detail how transformative experience has been analysed in the recent literature, before outlining in Sect. 3 the theoretical basis of the principle of informed consent, which plays a central role in how clinicians are expected to support decision-making. In Sect. 4, having laid the groundwork for a clear description, we return to the cases given in Sect. 1 to confirm how their transformative nature presents a problem: either clinicians treat the decisions faced by these patients as ‘normal’, encouraging them to focus on information provision that patients may be unable to act on, or they treat them as transformative, in which case they lack the resources to recognise whether they are helping patients make (subjectively) good decisions. In Sect. 5 we argue that the existing literature does not offer any escape from this problem. We close in Sect. 6 by noting the significant impact that appreciating the problem of transformative experience could have on supporting transformative decisions in medicine and briefly suggesting how we might aim to develop new approaches to dealing with these. (shrink)

Last year saw the 20th anniversary edition of JECP, and in the introduction to the philosophy section of that landmark edition, we posed the question: apart from ethics, what is the role of philosophy ‘at the bedside’? The purpose of this question was not to downplay the significance of ethics to clinical practice. Rather, we raised it as part of a broader argument to the effect that ethical questions – about what we should do in any given situation – are (...) embedded within whole understandings of the situation, inseparable from our beliefs about what is the case, what it is that we feel we can claim to know, as well as the meaning we ascribe to different aspects of the situation or to our perception of it. Philosophy concerns fundamental questions: it is a discipline requiring us to examine the underlying assumptions we bring with us to our thinking about practical problems. Traditional academic philosophers divide their discipline into distinct areas that typically include logic: questions about meaning, truth and validity; ontology: questions about the nature of reality, what exists; epistemology: concerning knowledge; and ethics: how we should live and practice, the nature of value. Any credible attempt to analyse clinical reasoning will require us to think carefully about these types of question and the relationships between them, as they influence our thinking about specific situations and problems. So, the answers to the question we posed, about the role of philosophy at the bedside, are numerous and diverse, and that diversity is illustrated in the contributions to this thematic edition. (shrink)

This is not a perfect book, but it is unique, and if you skim the first 400 or so pages, the last 300 (of some 700) are a pretty good attempt to apply what's known about behavior to social changes in violence and manners over time. The basic topic is: how does our genetics control and limit social change? Surprisingly he fails to describe the nature of kin selection (inclusive fitness) which explains much of animal and human social life. (...) He also (like nearly everyone) lacks a clear framework for describing the logical structure of rationality (LSR—John Searle’s preferred term) which I prefer to call the Descriptive Psychology of Higher Order Thought (DPHOT). He should have said something about the many other ways of abusing and exploiting people and the planet, since these are now so much more severe as to render other forms of violence nearly irrelevant. Extending the concept of violence to include the global long-term consequences of replication of someone’s genes, and having a grasp of the nature of how evolution works (i.e., kin selection) will provide a very different perspective on history, current events, and how things are likely to go in the next few hundred years. One might start by noting that the decrease in physical violence over history has been matched (and made possible) by the constantly increasing merciless rape of the planet (i.e., by people's destruction of their own descendant’s future). Pinker (like most people most of the time) is often distracted by the superficialities of culture when it’s biology that matters. See my recent reviews of Wilson’s ‘The Social Conquest of Earth’ and Nowak and Highfield’s ‘SuperCooperators’ here and on the net for a brief summary of the vacuity of ‘true altruism’ (group selection), and the operation of kin selection and the uselessness and superficiality of describing behavior in cultural terms. -/- This is the classic nature/nurture issue and nature trumps nurture --infinitely. What really matters is the violence done to the earth by the relentless increase in population and resource destruction (due to medicine and technology and conflict suppression by police and military). About 200,000 more people a day (another Las Vegas every 10 days, another Los Angeles every month), the 6 tons or so of topsoil going into the sea/person/year –about 1% of the world’s total disappearing yearly, etc. mean that unless some miracle happens the biosphere and civilization will largely collapse during next two centuries, and there will be starvation, misery and violence of every kind on a staggering scale. People's manners, opinions and tendencies to commit violent acts are of no relevance unless they can do something to avoid this catastrophe, and I don't see how that is going to happen. There is no space for arguments, and no point either (yes I'm a fatalist), so I'll just make a few comments as though they were facts. Don't imagine I have a personal stake in promoting one group at the expense of others. I am 78, have no descendants and no close relatives and do not identify with any political, national or religious group and regard the ones I belong to by default as just as repulsive as all the rest. -/- Parents are the worst Enemies of Life on Earth and, taking the broad view of things, women are as violent as men when one considers the fact that women's violence (like most of that done by men) is largely done in slow motion, at a distance in time and space and mostly carried out by proxy -by their descendants and by men. Increasingly, women bear children regardless of whether they have a mate and the effect of stopping one woman from breeding is on average much greater than stopping one man, since they are the reproductive bottleneck. One can take the view that people and their offspring richly deserve whatever misery comes their way and (with rare exceptions) the rich and famous are the worst offenders. Meryl Streep or Bill Gates or J.K Rowling and each of their kids may destroy 50 tons of topsoil each per year for generations into the future, while an Indian farmer and his may destroy 1 ton. If someone denies it that's fine, and to their descendants I say "Welcome to Hell on Earth"(WTHOE). -/- The emphasis nowadays is always on Human Rights, but it is clear that if civilization is to stand a chance, Human Responsibilities must replace Human Rights. Nobody gets rights without being a responsible citizen and the first thing this means is minimal environmental destruction. The most basic responsibility is no children unless your society asks you to produce them. A society or a world that lets people breed at random will always be exploited by selfish genes until it collapses (or reaches a point where life is so horrific it's not worth living). If society continues to maintain Human Rights as primary, to their descendants one can say with confidence "WTHOE". -/- Those wishing a comprehensive up to date framework for human behavior from the modern two systems view may consult my book ‘The Logical Structure of Philosophy, Psychology, Mind and Language in Ludwig Wittgenstein and John Searle’ 2nd ed (2019). Those interested in more of my writings may see ‘Talking Monkeys--Philosophy, Psychology, Science, Religion and Politics on a Doomed Planet--Articles and Reviews 2006-2019 3rd ed (2019), The Logical Structure of Human Behavior (2019), and Suicidal Utopian Delusions in the 21st Century 4th ed (2019) . (shrink)

Discussions concerning whether there is a natural right to health care may occur in various forms, resulting in policy recommendations for how to implement any such right in a given society. But health care policies may be judged by international standards including the UN Universal Declaration of Human Rights. The rights enumerated in the UDHR are grounded in traditions of moral theory, a philosophical analysis of which is necessary in order to adjudicate the value of specific policies designed to enshrine (...) rights such as a right to health care. We begin with an overview of the drafting of the UDHR and highlight the primary influence of natural law theory in validating the rights contained therein. We then provide an explication of natural law theory by reference to the writings of Thomas Aquinas, as well as elucidate the complementary “capabilities approach” of Martha Nussbaum. We conclude that a right to health care ought to be guaranteed by the state. (shrink)

Natural basis of the Sophistic conception of man — an outline. Following the tradition of the philosophy of nature, influenced by hippocratic medicine, Sophists claim that human-being is a biological creature, a part of the world of nature, subject to its rules and rights. Convinced that human-being is a composition of physical and spiritual elements and interested in the relation between the two, the Sophists examine the impact of psychological and physical stimuli on human behaviour. They take (...) under scrutiny various human states (pathe) such as sleep, wakefulness, sickness, madness, love, hatred. They emphasize the uniqueness and "private" character of individual perceptions and states which are dependent on the particular situation of a given subject. For these reasons, as they maintain, the nature of human cognition must be "private", fragmentary and limited. (shrink)

It is very well known that from the late-1960s onwards Feyerabend began to radically challenge some deeply-held ideas about the history and methodology of the sciences. It is equally well known that, from around the same period, he also began to radically challenge wider claims about the value and place of the sciences within modern societies, for instance by calling for the separation of science and the state and by questioning the idea that the sciences served to liberate and ameliorate (...) human societies. But what is less known is how, if at all, these two sets of challenges were connected, and why Feyerabend felt it important to raise them at all. In this chapter, my aim is to explore these issues by considering why Feyerabend used radical strategies to challenge the authority of science, and what purpose, if any, they were supposed to serve. Why, for instance, did Feyerabend defend alternative medicine, psychical abilities, astrology, magic and witchcraft and why did he argue that ‘Western science’ is complicit in environmental destruction, intellectual imperialism, social oppression, and spiritual destitution. Located in their historical and political context, such defences and arguments seem peculiar, not least because science was recognised not only as a central site of the intellectual and ideological competition between the West and the Soviet Union, but also because Western victory in that site was considered inevitable. What, then, did Feyerabend think he was trying to achieve by raising radical challenges to a central component of the cultural and intellectual prestige of the Western world grounded in appeals to practices and traditions which most would regard as eccentric at best and absurd at worst? My suggestion is that Feyerabend was making a subtler point than one might suppose. For the purpose of these radical challenges was to determine if the members of Western societies would in fact honour the epistemic standards – of tolerance, critical enquiry – which were identified as being characteristic of science and definitive of the social and political values of Western liberal democracy. I suggest that Feyerabend was trying to demonstrate that scientists were, too often, guilty of the same intolerant and dogmatic attitudes which were, according to prevailing propaganda, the property of illiberal totalitarian societies. Science does not reflect the superior epistemic and political values of Western societies but are, in fact, reflective of the same vices ascribed to the Soviet Union. If that is the case, then the sciences are not symbols of our epistemic and political values, but quite the reverse, hence Feyerabend’s talk of the ‘dogmatic’, ‘totalitarian’, ‘ratiofascist’ nature of modern science. But there is a positive upshot to Feyerabend’s challenge. For even if the sciences do not yet reflect the epistemic and political values of liberal democratic Western societies, they might yet be reformed so that they are. And there is a parallel between Feyerabend’s strategy and that of many of the other radicals of the time – student activists, environmentalists, and pacifists – namely to test the commitment to tolerance and deliberative debate of the establishment by asking it to seriously engage with ideas and convictions opposed to its own. For both science and society can become ‘tyrannical’ through the same means: by exempting themselves from critical scrutiny, by promoting self-serving ‘myths’ about themselves, and by derogating and excluding alternatives, including the ‘outsider’ perspectives they offer. The chapter concludes by suggesting that Feyerabend is distinctive in virtue of his willingness to offer radical criticisms of the authority of science such that it can fulfil its legitimate ideological role – namely, of symbolising and instantiating our core epistemic and political values – such that we can offer a sincere and meaningful answer to Feyerabend’s question ‘what’s so great about science?’. (shrink)

Precision medicine and molecular systems medicine (MSM) are highly utilized and successful approaches to improve understanding, diagnosis, and treatment of many diseases from bench-to-bedside. Especially in the COVID-19 pandemic, molecular techniques and biotechnological innovation have proven to be of utmost importance for rapid developments in disease diagnostics and treatment, including DNA and RNA sequencing technology, treatment with drugs and natural products and vaccine development. The COVID-19 crisis, however, has also demonstrated the need for systemic thinking and transdisciplinarity and (...) the limits of MSM: the neglect of the bio-psycho-social systemic nature of humans and their context as the object of individual therapeutic and population-oriented interventions. COVID-19 illustrates how a medical problem requires a transdisciplinary approach in epidemiology, pathology, internal medicine, public health, environmental medicine, and socio-economic modeling. Regarding the need for conceptual integration of these different kinds of knowledge we suggest the application of general system theory (GST). This approach endorses an organism-centered view on health and disease, which according to Ludwig von Bertalanffy who was the founder of GST, we call Organismal Systems Medicine (OSM). We argue that systems science offers wider applications in the field of pathology and can contribute to an integrative systems medicine by (i) integration of evidence across functional and structural differentially scaled subsystems, (ii) conceptualization of complex multilevel systems, and (iii) suggesting mechanisms and non-linear relationships underlying the observed phenomena. We underline these points with a proposal on multi-level systems pathology including neurophysiology, endocrinology, immune system, genetics, and general metabolism. An integration of these areas is necessary to understand excess mortality rates and polypharmacological treatments. In the pandemic era this multi-level systems pathology is most important to assess potential vaccines, their effectiveness, short-, and long-time adverse effects. We further argue that these conceptual frameworks are not only valid in the COVID-19 era but also important to be integrated in a medicinal curriculum. (shrink)

I review this report of an old medical congress on reproductive medicine. Much has happened in the 17 years since its publication but the most urgent task of preventing further population growth has largely failed on a global scale. I try to bring it up to date and briefly discuss the inexorable disaster coming as the world population passes 11 billion in the 22nd century. -/- Those wishing a comprehensive up to date framework for human behavior from the modern (...) two systems view may consult my book ‘The Logical Structure of Philosophy, Psychology, Mind and Language in Ludwig Wittgenstein and John Searle’ 2nd ed (2019). Those interested in more of my writings may see ‘Talking Monkeys--Philosophy, Psychology, Science, Religion and Politics on a Doomed Planet--Articles and Reviews 2006-2019 3rd ed (2019), The Logical Structure of Human Behavior (2019), and Suicidal Utopian Delusions in the 21st Century 4th ed (2019). (shrink)

From the Philosophies journal program, one of the main aims of the journal is to help establish a new unity in diversity in human knowledge, which would include both “Wissen” (i.e., “Wissenschaft”) and “sc¯ıre” (i.e., “science”). As is known, “Wissenshaft” (the pursuit of knowledge, learning, and scholarship) is a broader concept of knowledge than “science”, as it involves all kinds of knowledge,including philosophy, and not exclusively knowledge in the form of directly testable explanations and predictions. The broader notion of scholarship (...) incorporates an understanding and articulation of the role of the learner and the process of the growth of knowledge and its development, rather than only the final product and its verification and validation. In other words, it is a form of knowledge that is inclusive of both short-term and long-term perspectives; it is local and global, critical and hypothetical (speculative), breaking new ground. This new synthesis or rather re-connection of knowledge is expected to resonate with basic human value systems, including cultural values. Since knowledge tends to spontaneously fragment while it grows, we take existing diversity as a resource and a starting point for a new synthesis. The idea of broad, inclusive knowledge is in fact not so new. From the beginning, natural philosophy included all contemporary knowledge about nature. Newton was a natural philosopher, as were Bohr, Einstein, Prigogine, Weizsäcker, and Wheeler—to name but a few. Today, the unifying picture of the natural/physical world is sorely missing among the isolated silos of particular scientific domains, each with its own specific ontologies, methodologies, and epistemologies. From the profound need for connected and common knowledge, new trends towards synthesis have emerged in the last decades. One major theme is complexity, especially when applied to biology or medicine, which helps us to grasp the importance of connectedness between present-day disparate pieces of knowledge—frameworks, theories, approaches, etc. Related to this is the emergence of network science, which studies structures of nodes (actors) and edges as connections between them. This book is connecting work on contemporary natural philosophy and its connections with existing philosophies, sciences and other knowledge fields. (shrink)

We have been accustomed at least since Kant and mainstream history of philosophy to distinguish between the ‘mechanical’ and the ‘teleological’; between a fully mechanistic, quantitative science of Nature exemplified by Newton and a teleological, qualitative approach to living beings ultimately expressed in the concept of ‘organism’ – a purposive entity, or at least an entity possessed of functions. The beauty of this distinction is that it seems to make intuitive sense and to map onto historical and conceptual constellations (...) in medicine, physiology and the related natural -philosophical discussions on the status of the body versus that of the machine. In this presentation I argue that the distinction between mechanism and teleology is imprecise and flawed, on the basis of a series of examples: the presence of ‘functional’ or ‘purposive’ features even in Cartesian physiology; work such as that of Richard Lower’s on animal respiration; the fact that the model of the ‘body-machine’ is not at all a mechanistic reduction of organismic properties to basic physical properties but on the contrary a way of emphasizing the uniqueness of organic life; and the concept of ‘animal economy’ in vitalist medical theory, which I present as a kind of ‘teleo-mechanistic’ concept of organism – neither mechanical nor teleological. (shrink)

In this paper I articulate and defend a view that I call phenomenal dogmatism about intuitive justification. It is dogmatic because it includes the thesis: if it intuitively seems to you that p, then you thereby have some prima facie justification for believing that p. It is phenomenalist because it includes the thesis: intuitions justify us in believing their contents in virtue of their phenomenology—and in particular their presentational phenomenology. I explore the nature of presentational phenomenology as it occurs (...) perception, and I make a case for thinking that it is present in a wide variety of logical, mathematical, and philosophical intuitions. (shrink)

Purpose: The purpose of the discussion is to call for an experimental trial in order to optimize the sociology of knowledge in the astronomical and cosmological sciences from a cognitive science and developmental psychology perspective. The potential of such experimental trial may also correlate developmental psychology with cosmology and astrophysics, therefore, contribute to public health from an astrobiological perspective. -/- Method: The discussion adopts a philosophizing method for the multidisciplinary and trans-disciplinary proposal, with the hypothesis that proton decay in cosmology (...) is correlative to neuronal development in human biochemistry. The method adopts a humanitarian paradigm of pragmatism in natural mutation from cosmic changes, in an exploratory heuristics for hydro-sampling of mutational potentials from environmental factors in cosmological large-scale structure. -/- Result: With an initial assessment on existing technologies, the potentials of the big data trend in astronomy and astrophysics can be applied to data analysis with solid-state electrolytes in sensor baselines to nuclear medicine methods. (shrink)

Bad philosophy is responsible for the climate and nature crises, and other global problems too that threaten our future. That sounds mad, but it is true. A philosophy of science, or of theatre or life is a view about what are, or ought to be, the aims and methods of science, theatre or life. It is in this entirely legitimate sense of “philosophy” that bad philosophy is responsible for the crises we face. First, and in a blatantly obvious way, (...) those institutions, organizations, corporations, businesses, endeavours, and activities of humanity that cause the crises and global problems we face, do so because of the aims they pursue (profit perhaps, or power, or heat and light for homes), and the methods adopted in pursuit of those aims – the philosophy in other words, built into the institution, organization, business, human activities, or whatever it may be. It is the philosophy of these institutions, organizations and activities that we need to change to put a stop to, or at least lessen the severity of, the crises we face, the global problems that confront us, above all the climate and nature crises. One institution has an especially crucial role in this respect: our universities. They are dominated in a multitude of ways by a particularly disastrous philosophy, a philosophy of inquiry which may be called knowledge-inquiry. This holds that the basic aim of the university is to acquire and apply knowledge. First, knowledge is to be acquired; once acquired, it can be applied to help solve social problems. But this philosophy of knowledge-inquiry is an intellectual disaster. As a result, universities are, in devastating and almost entirely unrecognized ways, humanitarian disasters too. Judged from the standpoint of helping to promote human welfare, the university shaped by the philosophy of knowledge-inquiry violates THREE of the four most elementary rules of rational problem solving conceivable in a wholesale, structural fashion, and it is this gross, wholesale, structural irrationality of the university, unnoticed by all but a few scientists and scholars, that is in part responsible for the creation of our grave global problems, and our current incapacity to learn how to solve them. The pursuit of knowledge, conducted in universities, within the framework of knowledge-inquiry over the decades and centuries, has produced much of great benefit to humanity. It has made the modern world possible. It has led to modern power production, modern industry and armaments, modern agriculture, modern hygiene and medicine, modern travel and communications, and the internet. But these very successes have also created many of our most serious current global problems: the climate crisis; the destruction of natural habitats, the catastrophic loss of wild life, and impending mass extinction of species (the nature crisis); the lethal character of modern war; the impact on the natural world of the rapid growth of the human population; the menace posed by nuclear weapons; pollution of earth, sea and air; threats to democracy caused in part by the internet and social media. All these grave global problems have been made possible by modern science and technology, pursued largely in universities within the framework of knowledge-inquiry. Nevertheless, it is not science and technology as such that are the problem, but science pursued in a way that is dissociated from a more fundamental task of the university to help humanity resolve conflicts and problems of living in increasingly cooperatively rational ways, so that progress may be made to a better world. Science and technology, pursued within the framework of knowledge-inquiry, create for some of us the power to act, but not the power to act wisely – not the power to learn how to resolve conflicts and problems of living in increasingly cooperatively rational ways. For that, we need our institutions of learning, above all our universities, to take as their primary task to help humanity learn how to do it. In order to do that, the philosophy of inquiry put into practice by universities needs to be dramatically transformed. We urgently need to bring about a revolution in the overall aims and methods of academic inquiry – a revolution in the philosophy of the university, all around the world, wherever possible, so that the basic aim becomes to seek and promote wisdom, construed to be the capacity, active endeavour, and perhaps desire, to realize what is of value in life, for oneself and others, wisdom in this sense including knowledge, understanding and technological know-how, but much else besides, methods being dramatically modified too so as to help achieve the new academic aim. The basic task of the university would be, not to solve problems of knowledge, but rather to help people in the social world beyond the university to resolve conflicts and problems of living so that what is of value in life may be realized by everyone, insofar as that is possible. The pursuit of knowledge would be vital, but not intellectually fundamental. The intellectual and institutional revolution we so urgently need in our universities would affect every discipline and aspect of the university; it would dramatically affect both research and education, and the whole way the university is related to the rest of the social world. The revolution, from knowledge-inquiry to wisdom-inquiry would dramatically enhance the intellectual integrity and rationality of natural science, social inquiry, the humanities and technology, the character of these disciplines and the relationships they have with one another. University education throughout the university would be dramatically improved. And academic inquiry as a whole would do what, on the whole, it fails to do at present: it would help humanity resolve conflicts and problems of living in increasingly cooperatively rational and, as a result, increasingly successful ways, progress at last being made to a genuinely good, civilized world – a world in which there is peace, justice, liberal democracy, individual freedom, education, reasonable equality, sustainable prosperity and worthwhile opportunities in life, all of these for everyone, insofar as this is possible. Why, it may be asked, has academic philosophy not noticed that we urgently need to transform the current bad philosophy of inquiry of knowledge-inquiry into the far more intellectually rigorous and humanly valuable philosophy of wisdom-inquiry, so that we can begin to do what so far we have failed to do so lamentably: learn how to avoid impending disasters, and even make progress to a better world, something that seems at present almost unthinkable given the horrors of war, poverty, political enslavement of the 20th century, and the horrors of this century so far too? The answer is that academic philosophy is in a particularly pitiful state, as philosophers themselves, are just beginning to realize and lament. That is why academic philosophers are blind to the intellectual and humanitarian disaster of the bad philosophy that dominates universities today, and inconceivable to them to them that they might have, as a disciplinary task, to ensure academic inquiry implements a good philosophy of inquiry, and advocate and argue for change if it does not. Once upon a time, in Europe at least, philosophy was an intellectual power in the world. In the 17th century it created modern science which massively increased and improved our knowledge and understanding of the world, which in turn led to the Enlightenment, the industrial revolution, and the modern world. Philosophy was once so intellectually powerful and influential that it changed the course of history. But philosophy also made in the past three disastrous intellectual blunders: the post-Cartesian blunder, the post-Newtonian blunder, and the Enlightenment blunder. Never acknowledged and corrected by subsequent philosophy right down to the present, these unrecognized intellectual blunders rendered academic philosophy the esoteric, pathetic, and powerless discipline it is today, so that throughout the last century and, so far, throughout this one, academic philosophy has remained blind to the intellectual disaster of knowledge-inquiry, and thus failed entirely to take up its proper disciplinary task of warning fellow academics of the structural irrationality of the philosophy that prevails in the university, and of proposing what steps need to be taken to put things right. Instead of performing such an urgently needed philosophical task, so-called analytic philosophy was reduced to analysing the meaning of words. Since then, there has been hardly any discernible improvement, even if analysis of concepts no longer dominates the scene. Bad academic philosophy is indeed responsible for intellectual and humanitarian failures of the university. What the three past intellectual blunders of philosophy are, why their persistence so dramatically reduces academic philosophy to a triviality, and why, furthermore, this results in the failure of scientists and scholars to see what is so blatantly bad about the philosophy prevailing in universities around the world – the failure to see what so urgently needs to be done to put right what has been wrong for so long: all this is made clear in this book. A new kind of philosophy emerges during the course of the argument, critical fundamentalism, which has as its task to keep alive imaginative and critical – that is rational – thinking about our fundamental problem: How can our human world, the world we experience and live in – the world of living things, people, consciousness, free will, meaning and value – how can all of this exist and best flourish embedded as it is in the physical universe? That problem encompasses all others of life, science and thought. Critical fundamentalism tries to improve answers to aspects of this problem; but it also seeks to encourage everyone to think about the problem, from time to time, and think about how it interacts, in both directions, with more urgent particular and specialized problems of life and thought. Critical fundamentalism sets out to help improve bad philosophy wherever it is to be found: in social, political, commercial, legal, financial, and international life; and especially in academia, in institutions of learning, so that they become devoted to enhancing the capacity of people to learn how to achieve what is of genuine value in this brief life of a few decades if we are fortunate. Critical fundamentalism does everything it can to bring about the revolution in our universities we so urgently need. If taken up by mainstream philosophy, it might really have an impact, and begin to transform universities for the better, in both intellectual and humanitarian terms, and thus, enable humanity to learn how, after the grim failures and horrors of the last century and this one, to make progress to a better world. -/- . (shrink)

Dominant views about the nature of health and disease in bioethics and the philosophy of medicine have presumed the existence of a fixed, stable, individual organism as the bearer of health and disease states, and as such, the appropriate target of medical therapy and ethical concern. However, recent developments in microbial biology, neuroscience, the philosophy of cognitive science, and social and personality psychology (Ickes...

This article illustrates in which sense genetic determinism is still part of the contemporary interactionist consensus in medicine. Three dimensions of this consensus are discussed: kinds of causes, a continuum of traits ranging from monogenetic diseases to car accidents, and different kinds of determination due to different norms of reaction. On this basis, this article explicates in which sense the interactionist consensus presupposes the innate?acquired distinction. After a descriptive Part 1, Part 2 reviews why the innate?acquired distinction is under (...) attack in contemporary philosophy of biology. Three arguments are then presented to provide a limited and pragmatic defense of the distinction: an epistemic, a conceptual, and a historical argument. If interpreted in a certain manner, and if the pragmatic goals of prevention and treatment are taken into account, then the innate?acquired distinction can be a useful epistemic tool. It can help, first, to understand that genetic determination does not mean fatalism, and, second, to maintain a system of checks and balances in the continuing nature?nurture debates. (shrink)

The aim of this paper is to offer a comparative survey of Bacon's theory and practice of natural history and of civil history, particularly centered on their relationship to natural philosophy and human philosophy. I will try to show that the obvious differences concerning their subject matter encompass a number of less obvious methodological and philosophical assumptions which reveal a significant practical and con ceptual convergence of the two fields. Causes or axioms are prescribed as the theoretical end-products of natural (...) history, whereas precepts are envisaged as the speculative outcomes derived from perfect civil history. In spite of this difference, causes and precepts are thought to enable effective action in order to change the state of nature and of man, respectively. For that reason a number of common patterns are to be found in Bacon's theory and practice of natural and civil history. (shrink)

Is there a ‘common element’ in Buddhist ethical thought from which one might rationally reconstruct a Buddhist normative ethical theory? While many agree that there is such an element, there is disagreement about whether it is best reconstructed in terms that approximate consequentialism or virtue ethics. This paper will argue that two distinct evaluative relations underlie these distinct positions; an instrumental and constitutive analysis. It will raise some difficulties for linking these distinct analyses to particular normative ethical theories but will (...) give reasons to think that both analyses may be justified. It will close with some reflections on the complexity involved in trying to establish a single and homogeneous position on the nature of Buddhist ethics. (shrink)

The goal of this programmatic paper is to highlight a close connection between the core problem in the philosophy of medicine, i.e. the concept of health, and the core problem of the philosophy of mind, i.e. the concept of consciousness. I show when we look at these phenomena together, taking the evolutionary perspective of modern state-based behavioural and life-history theory used as the teleonomic tool to Darwinize the agent- and subject-side of organisms, we will be in a better position (...) to make sense of them both as natural phenomena. (shrink)

Many transhumanists see their respective movement as being rooted in ancient ethical thought. However, this alleged connection between the contemporary transhumanist doctrine and the ethical theory of antiquity has come under attack. In this paper, we defend this connection by pointing out a key similarity between the two intellectual traditions. Both traditions are committed to the “radical transformation thesis”: ancient ethical theory holds that we should assimilate ourselves to the gods as far as possible, and transhumanists hold that we should (...) enhance ourselves beyond the physical and intellectual parameters of being human so as to become posthuman. By considering the two views in tandem, we develop an account of the assimilation directive that is palatable to contemporary readers and provide a view of posthumanism worth wanting. (shrink)

My aim in this chapter is to take the complexity of our histories of rights as seriously as the nature of rights themselves. Let me say immediately that the point is not to satisfy our sense of moral superiority by smugly pointing out the prejudices found in arguments made over three hundred years ago. We have more than our own share of problems and prejudices to deal with. Rather, in coming to grips with this history, and especially how early-modern (...) political theorists struggled with the extension and application of natural rights to the ‘New World’, we may learn something about our own struggles to extend human rights beyond the boundaries of the state system of which Grotius, Hobbes, Locke and Vattel were among the key intellectual architects. For Richard Tuck, the autonomous rights-bearing agent at the heart of liberal individualism is a product of seventeenth-century theorizing about the nature of the autonomous state acting in the international sphere. The sovereign individual is the ‘traditional cousin of the sovereign state’, argues Tuck, and especially the aggressive, violent, and minimally constrained relative described by Hugo Grotius, Thomas Hobbes, John Locke and Emer de Vattel. Thus the connection between liberalism and imperialism, on this reading, is not merely chronological or historical but metaphysical. The analogy between the sovereign state and the sovereign individual acting on the basis of their natural rights, constrained by the recognition of the basic rights of others (but not much more than that) represents an influential vision of liberal freedom. This minimalist account of freedom represents only one vision, however, and Tuck’s account of the pre-history of liberal rights has to be balanced against other conceptions, including more emancipatory ones. (shrink)